10 Best Natural Ways to Relieve Hemorrhoids and Constipation

What Are Hemorrhoids and Constipation?

Hemorrhoids (Piles)

Hemorrhoids are clusters of swollen blood vessels, muscle, and tissue inside your anal canal. Everyone has them — they’re a normal part of your body. The problem only starts when they get too swollen, slip out of place, or cause symptoms. There are two types: internal hemorrhoids (inside the canal, usually painless) and external hemorrhoids (near the opening, often painful and itchy).

Internal hemorrhoids are graded I–IV using the Goligher classification: Grade I (swell but stay in place), Grade II (slip out but go back on their own), Grade III (have to be pushed back in manually), Grade IV (stay pushed out). Natural remedies work best for Grades I and II.

Constipation

Constipation means fewer than three bowel movements per week, along with symptoms like hard stools, straining, feeling like you can’t fully empty out, or bloating. When it lasts more than three months, it’s called chronic constipation. Doctors use the Rome IV criteria to diagnose it — you need at least two of these symptoms in more than a quarter of your bathroom visits over the past 12 weeks.

📖 Related: Constipation Relief: Best Fiber Foods and Fiber Therapy for Gut Health

Root Causes: Why Do They Happen?

The 2024 ASCRS Clinical Practice Guidelines (Hawkins et al., Dis Colon Rectum, DOI: 10.1097/DCR.0000000000003276) identify these as the main controllable risk factors:

1. Low-Fiber Diet

The average American only eats 10–15g of fiber a day — less than half of the 25–35g recommended by the 2024 ASCRS guidelines. Without enough fiber, stools become hard and dry, forcing you to strain harder to pass them. That extra straining puts direct pressure on the blood vessels that become hemorrhoids. A 2022 systematic review in the American Journal of Clinical Nutrition confirmed that fiber supplementation — especially psyllium at doses above 10g/day — significantly helps with chronic constipation (van der Schoot et al., DOI: 10.1093/ajcn/nqac184).

2. Straining During Bowel Movements

When you strain, you increase pressure inside your belly and rectum — and that pressure swells the blood vessels that turn into hemorrhoids. Garg & Singh (2017) showed in a PubMed-indexed study that fixing straining habits, combined with enough fiber, helped most patients with even Grade III hemorrhoids avoid surgery (DOI: 10.23736/S1121-421X.17.02364-9).

3. Spending Too Long on the Toilet

Sitting on the toilet for more than 10 minutes at a stretch — especially while scrolling your phone or reading — puts direct pressure on the blood vessels around your bottom. The ASCRS guidelines specifically recommend cutting down toilet time as a first-line behavioral change.

4. Pregnancy

As the uterus grows, it presses on the veins in the pelvis. On top of that, higher progesterone levels during pregnancy relax the walls of blood vessels — both of which dramatically raise the risk of hemorrhoids in the third trimester and after delivery.

5. Sitting Too Much and Carrying Extra Weight

Not moving enough slows down the natural contractions your colon uses to push stool through. Carrying extra weight increases pressure in your belly and slows blood flow out of the pelvic area, making hemorrhoids worse. That’s why exercise shows up as a first-line recommendation in every major clinical guideline.

6. Not Drinking Enough Water

When you’re dehydrated, your colon pulls extra water out of your stool to compensate — leaving behind dry, hard stool that’s much harder to pass. Drinking 6–8 glasses of fluid a day is essential for dietary fiber to do its job.

7. Getting Older

The tissue that holds hemorrhoids in place naturally weakens with age, making them more likely to slip out of position after age 45–50. That’s why hemorrhoid rates climb so sharply as people get older.

📖 Related: Is Your Cooking Oil Causing Constipation? Plastic Bottle Dangers

Symptoms: How to Recognize Them

Hemorrhoid Symptoms

The classic sign of internal hemorrhoids is bright-red, painless rectal bleeding during or after a bowel movement — you’ll see it on toilet paper or in the bowl. Other symptoms include itching around your bottom, mucus discharge, and a feeling like you haven’t fully emptied out. In Grades III–IV, tissue pushes out through the anal opening.

External hemorrhoids are painful because the skin around the anal opening has a lot of nerve endings. A blood clot forming inside an external hemorrhoid (called a thrombosed hemorrhoid) shows up as a sudden, very painful lump near your bottom.

Constipation Symptoms

Beyond fewer than three bowel movements a week, symptoms include hard or lumpy stools, feeling like something is blocking you, having to strain a lot, and a sense that you still need to go after you’re done. Bloating and belly discomfort are also common.

🚨 Get Medical Attention Right Away If You Have: Dark or maroon-colored rectal blood; blood mixed into the stool (not just on the paper); unexplained weight loss; a persistent change in your bathroom habits lasting 3+ weeks; or a hard lump near your bottom that won’t go back in. These can be signs of colorectal cancer, inflammatory bowel disease, or a blood clot in a hemorrhoid — never assume bleeding is “just hemorrhoids” without a doctor’s confirmation.

10 Natural Ways to Relieve Hemorrhoids and Constipation

Every remedy below is backed by published research — with clickable DOI links so you can check the evidence yourself.

🌾 Remedy #1: High-Fiber Diet — The Most Important Step

🔬 Cochrane Meta-Analysis | ASCRS Grade A Recommendation

A Cochrane-registered systematic review by Alonso-Coello et al. looked at 7 randomized controlled trials and found that adding fiber to your diet cut the risk of persistent hemorrhoid symptoms by 53% and consistently reduced bleeding across every trial included. This is the strongest evidence behind any non-surgical hemorrhoid treatment.

The 2024 ASCRS guidelines specifically identify adequate dietary fiber as the foundation of first-line management. Your target should be 25–35g of fiber per day to effectively manage symptoms and prevent flare-ups.

Best food sources: oat bran, lentils, chickpeas, kidney beans, split peas, raspberries, blackberries, pears, prunes, whole grain bread, and flaxseed.

⚡ How to Start Safely: Increase fiber by no more than 5g per week to avoid bloating and gas. Every increase in fiber needs to come with more water too — fiber without enough water can actually make constipation worse.

📄 Reference: Alonso-Coello P et al. Am J Gastroenterol. 2006. (Journal publication of a Cochrane-registered systematic review).

📖 Related: Constipation Relief: Best Fiber Foods and Fiber Therapy for Gut Health

💧 Remedy #2: Consistent Hydration

🔬 Clinical Consensus | Essential Partner to Fiber

Water is fiber’s best friend. Without enough fluid, even a high-fiber diet can create a bulky, dry mass that’s hard to pass. All major guidelines recommend 6–8 glasses (about 1.5–2 liters) of non-caffeinated fluids daily alongside fiber for both constipation and hemorrhoid management.

Warm water — especially first thing in the morning — triggers your gastrocolic reflex, a natural body response that sets off contractions in your colon and gets things moving. Adding a squeeze of lemon (mild acidity) can help kick-start this reflex even more.

⚡ Daily Routine: Drink a large glass (about 10–14 oz) of warm water when you wake up, before coffee or food. Aim for 2 liters total throughout the day. Cut back on alcohol and caffeine — both pull water out of your body and can make constipation worse.

🛁 Remedy #3: Warm Sitz Baths

🔬 ASCRS Recommended | Symptom Relief Confirmed

A warm sitz bath — soaking your bottom in plain warm water for 10–15 minutes, 2–3 times a day — is one of the most consistently recommended home treatments by colorectal surgeons. Here’s why it works: warm water relaxes the muscle ring around your anal opening (reducing spasms), improves blood flow to the area, and helps bring down swelling in hemorrhoid tissue. The result is direct relief from pain, itching, and burning.

One important note: no additive (Epsom salt, essential oils, soap) has been shown in clinical trials to work better than plain warm water. Some additives can actually irritate sensitive skin down there. Plain warm water is both the evidence-based and safest choice.

⚡ How to Do It Right: Fill a bathtub or sitz bath basin (available at any pharmacy for around $10) with 3–4 inches of comfortably warm — not hot — water. Soak for 10–15 minutes. Pat dry (don’t rub) with a soft towel afterward. Most helpful right after a bowel movement during a flare.

🌱 Remedy #4: Psyllium Husk Fiber Supplement

🔬 The Only Fiber Recommended by Both AGA & ACG for Constipation

Psyllium husk is the most well-researched fiber supplement you can buy. It’s the only isolated fiber that both the American College of Gastroenterology and the American Gastroenterological Association explicitly recommend for chronic constipation. A Cochrane-registered review confirms it reduces hemorrhoid symptoms and bleeding. A 2022 meta-analysis by van der Schoot et al. (16 RCTs, 1,251 participants) confirmed that psyllium specifically — at doses above 10g/day — significantly improved constipation outcomes (RR 1.48, p=0.001).

A study by Garg et al. (2017) demonstrated the high effectiveness of psyllium husk in managing advanced hemorrhoids. Building on this, the latest data from a WJGS 2025 paper shows that 87.1% of patients avoided surgery through consistent conservative management, while reporting a 81.9% patient satisfaction rate over the follow-up period.

⚡ How to Use It: Start with 1 teaspoon (5g) in a full glass of water once a day. Gradually work up to 2–3 teaspoons twice daily as your body adjusts. Always drink a second full glass of water right after — psyllium that doesn’t get enough water can swell in your throat. Take it at least 2 hours away from any medications.

📄 van der Schoot A et al. Am J Clin Nutr. 2022;116(4):953–969. DOI: 10.1093/ajcn/nqac184 | Garg P, Singh P. Minerva Gastroenterol Dietol. 2017;63:92–96. DOI: 10.23736/S1121-421X.17.02364-9

📖 Related: Psyllium Husk vs Wheat Bran for Constipation: Which Is Better?

🍃 Remedy #5: Witch Hazel

🔬 Evidence-Based Topical Treatment | PMC Literature Review 2024

Witch hazel is one of the most well-studied herbal treatments for hemorrhoids. A 2024 PMC literature review confirmed that its active compounds — tannins and gallic acid — tighten swollen blood vessel walls, reduce inflammation, and create a temporary protective layer on irritated skin around the bottom. This cuts down on itching, burning, and swelling in both internal and external hemorrhoids, and it’s gentle enough to use after every bowel movement. Witch hazel is the active ingredient in TUCKS medicated pads and is used in hospitals for post-surgical care.

⚡ How to Use It: Apply a pure witch hazel solution (at least 14% tannin concentration) on a soft cotton pad. Press — don’t rub — gently against the affected area after each bowel movement. Can be used 3–6 times a day. Pre-soaked medicated pads (TUCKS) give you a consistent dose and are very convenient.

📄 PMC Review: Natural Products with Potential Effects on Hemorrhoids. Molecules. 2024;29(11):2673. DOI: 10.3390/molecules29112673

🌿 Remedy #6: Aloe Vera — Topical Anti-Inflammatory

🔬 Traditional Medicine + Plant-Based Evidence

Aloe vera has been used to treat anal and rectal conditions across multiple cultures, and modern research backs it up. Aloe gel contains plant compounds, polysaccharides, and soothing mucilage that work together to reduce inflammation, fight bacteria, and support skin healing. Applied on the outside, aloe vera eases the burning and inflammation of external hemorrhoids and helps heal irritated skin around the bottom. The cooling effect of refrigerated aloe gel also gives fast symptom relief.

Note: concentrated aloe latex (from the inner rind of the leaf) contains strong laxative compounds and is not recommended for internal use without medical supervision.

⚡ How to Use It: Apply 100% pure, cold-pressed aloe vera gel (no alcohol, fragrance, or dyes) directly to the external hemorrhoid 2–3 times a day. Putting the gel in the fridge for 30 minutes before applying makes the cooling, anti-inflammatory effect even stronger.

🍊 Remedy #7: Bioflavonoids — Diosmin + Hesperidin (MPFF)

🔬 Multiple RCTs | ASCRS 2024 Guidelines — Strongest Herbal Evidence

Among all oral natural supplements for hemorrhoids, diosmin and hesperidin (Micronized Purified Flavonoid Fraction, or MPFF) have the strongest body of clinical trial evidence. The 2024 ASCRS guidelines explicitly cite flavonoids (called phlebotonics) as having solid evidence for improving acute hemorrhoid flares and reducing how often they come back.

Key trial data: a 120-person double-blind study found meaningful cuts in how often and how severely hemorrhoid flares happened; a 100-person trial showed real symptom relief during acute episodes; a 90-day trial in 100 patients with bleeding hemorrhoids found benefits for both acute treatment and preventing recurrence. How they work: diosmin and hesperidin strengthen vein walls, reduce leakiness in blood vessels, and ease swelling in hemorrhoid tissue.

Horse chestnut seed extract (standardized to 20% aescin) works in a similar way and falls into the same evidence category.

⚡ Dosage Used in Trials: 450mg diosmin + 50mg hesperidin (= 500mg MPFF) twice daily with meals during an acute flare. For prevention: once daily for 3–6 months. Always choose products labeled “micronized” — regular-size diosmin particles are poorly absorbed by the body.

📄 EBSCO Research Starters: Natural Treatments for Hemorrhoids. View source | ASCRS Guidelines 2024. DOI: 10.1097/DCR.0000000000003276

🏃 Remedy #8: Regular Physical Activity

🔬 Improves Gut Movement | Reduces Blood Pooling

Exercise helps both constipation and hemorrhoids in two direct ways: (1) it speeds up how quickly your colon moves stool — the natural muscle contractions that push things forward — which significantly cuts down on constipation; (2) it improves blood flow out of the pelvic area, reducing the blood pooling in rectal vessels that causes hemorrhoids to swell. Even moderate walking has been shown in clinical studies to meaningfully reduce how often and how severely constipation occurs.

Not all exercise is equally helpful during an active flare, though. Heavy weightlifting and intense cycling temporarily increase pressure in your belly and may make symptoms worse in the short term.

⚡ Exercise Plan: Aim for 30 minutes of moderate cardio (brisk walking, swimming, elliptical) five days a week. During a flare: stick to gentle walking and yoga. Avoid heavy squats, deadlifts, or cycling until symptoms calm down.

🍑 Remedy #9: Prunes, Kiwi & Natural Laxative Foods

🔬 RCT Evidence for Prunes vs. Psyllium | Kiwi Enzyme Research

Prunes (dried plums) contain both soluble fiber and sorbitol — a natural sugar alcohol with a well-documented osmotic laxative effect that draws water into the colon to soften stool. A randomized clinical trial in Aliment Pharmacol Ther (Attaluri et al., 2011, DOI: 10.1111/j.1365-2036.2011.04594.x) compared dried prunes directly against psyllium in constipated adults and found prunes were better at increasing stool frequency and improving consistency.

Kiwi fruit contains actinidin, a natural enzyme shown in multiple clinical trials to speed up digestion and improve how quickly stool moves through your gut. It also contains pectin (a soluble fiber) and is one of the most well-studied whole foods for constipation relief.

⚡ How to Use Them: Eat 3–5 dried prunes with breakfast daily (or drink 4–6 oz of pure prune juice); and/or eat 2 kiwi fruits daily. Most people notice a difference in stool consistency within 24–72 hours of starting regularly.

📖 Related: How Long Does It Take for Prune Juice to Work? (1–3 Hours?)

🦠 Remedy #10: Probiotics for Gut Health

🔬 Strong and Growing Evidence | Especially Helpful After Antibiotics

The bacteria living in your gut play a key role in keeping your bowel movements regular, your stools soft, and your colon calm. Randomized controlled trials show that specific probiotic strains — particularly Lactobacillus rhamnosus GG, Bifidobacterium longum, Bifidobacterium lactis, and Lactobacillus acidophilus — significantly speed up gut transit, improve how often you go, and improve stool consistency in constipated adults. All of this directly cuts down on straining and hemorrhoid risk.

Probiotics are especially helpful after antibiotic use (which wipes out good gut bacteria and commonly triggers constipation) and during pregnancy (when many standard laxatives are off the table).

⚡ What to Look For: A multi-strain formula with at least 10 billion CFUs; should contain both Lactobacillus and Bifidobacterium strains. Take with a meal — food protects the probiotics from stomach acid and helps more survive to reach your gut. Give it at least 4–8 weeks before judging whether it’s working.

📖 Related: 9 Best Probiotic Supplements 2026: Expert Guide for Gut Health & Immunity | Safe Probiotics for Pregnancy-related Constipation

The 10 remedies above give you a research-backed foundation for long-term gut healing. If you want to get there faster, the right over-the-counter products can work hand-in-hand with everything above.

The ASCRS 2024 guidelines and the broader colorectal surgery literature agree: conservative management is not just a temporary fix — it is the most effective long-term strategy for preventing recurrence, including after interventional procedures.

The TONE Method: A Clinically Proven Behavioral Protocol

Garg (2017, PMC: PMC5711722) proposed the TONE mnemonic, validated in multiple PubMed-indexed studies: Three minutes maximum at defecation; Once-a-day bowel frequency goal; No straining, no phone, no newspaper; Enough fiber (30–35g/day with 500ml water). Following TONE corrects the three root defecation behaviors responsible for hemorrhoid development and progression — and has been shown to avoid surgery in the majority of even advanced-grade hemorrhoid patients when maintained consistently.

Natural and OTC treatments are appropriate for Grade I–II hemorrhoids and mild-to-moderate constipation. The following situations always require prompt professional medical evaluation:

For Grade II–III hemorrhoids unresponsive to conservative management, minimally invasive office procedures — rubber band ligation, sclerotherapy, or infrared coagulation — are effective and typically performed without anesthesia. Surgical hemorrhoidectomy is reserved for Grade III–IV disease failing all other treatments.